Everyone, even your dentist, knows that when we age, we see certain changes in our face (for example, wrinkled skin, less skin tone, shrunken appearance). The soft tissue in the lower one-third of the face is supported by the teeth and jawbone, and gives support to your smile. As we age, we lose support to our smile and we begin to appear older.

Anatomically, the face is divided into thirds: the upper, middle and lower one-third. The space between your nose and your chin is referred to as the lower one-third. The teeth support the vertical height of your lower face, and more specifically the back teeth support your lower face.

Most dentists agree that minimal and gradual wearing away of the top enamel of the teeth is considered normal during the lifespan of a patient. However, excessive wear on the top surfaces of the teeth can result in abscessed teeth, an irregular bite, decreased chewing capacity and esthetic disharmony. Patients with these types of problems often require extensive restorative cosmetic dentistry treatment.

How Common Is Tooth Wear?

Although the prevalence of tooth wear, or attrition, is not known, it is thought to be very common in adults over the age of 40. The wearing of the top surfaces of the teeth is most often attributed to attrition, which is the wearing away of one tooth surface by another tooth surface. Attrition is the result of bruxism, or the involuntary grinding of the teeth against each other.

How Does Attrition Occur?

Attrition can be the result of one or a combination of problems such as:

Congenital Abnormalities: Hereditary abnormalities can cause the malformation of the surfaces of the teeth. This can result in a thin and/or brittle outer layer of the tooth. This leaves the tooth more susceptible to surface wear and a more rapid attrition of tooth structure.

Parafunctional Habits: One type of parafunctional habit is bruxism, as explained above. Other habits often associated with attrition include biting on needles, pipe stems, pencils, or finger nails as well as clenching. Many studies have related stress to attrition.

Abrasion: It is defined as the wearing away of tooth tissue through mechanical processes. The top surfaces of the teeth are abraded away usually by diet, chewing of abrasives such as tobacco and environmental factors such as constant exposure to dust and grit (in farming).

Erosion: Erosion is the destruction of hard dental tissues by chemical action. Diets high in acidic content like juices, colas and other carbonated drinks are examples of the foods that cause erosion. Patients who suffer from anorexia nervosa or bulimia are prime examples of erosion due to the high acid nature of stomach acids that are constantly regurgitated into the mouth.

What Is the Result of Worn Teeth?

Depending on the severity of the tooth wear, teeth may be broken, shortened and unattractive. Having worn teeth can result in jaw joint pain (TMJ), a decreased ability to chew and a sunken appearance to the lower face. All of these results can make a person appear more wrinkled and older.

Can Worn Teeth Be Fixed with Fillings?

Generally, the worn teeth will have to have new fillings placed or redone. When severe wear occurs in the mouth, a dental crown or multiple crowns may be the only solution.

Can Tooth Wear Be Prevented?

Yes, tooth wear can be prevented, but only if you make regular visits to the dentist. If detected early enough, your dentist may prescribe a plastic night guard to protect your teeth, much like an athletic mouth guard.

By Benjamin O. Watkins, III, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

How Aesthetic Dentistry Can Enhance Your Appearance

The color, size, and shape of your teeth all have a profound impact on your appearance. While it is often the desire of people to improve the look of their smiles, it should be the goal of aesthetic dentistry, or cosmetic dentistry, to do this while still maintaining a "natural" appearance of the teeth. This often requires addressing one or all of the above-mentioned criteria. How is it that alterations in these three characteristics enhance your smile?

Color of Your Teeth

Tooth color is most commonly what people see first. As you get older, your teeth get darker. The reasons for this include normal changes that occur within the tooth and repeated insults from environmental conditions (coffee or tea stains, for example). Generally, then, darker teeth are associated with older age. The easiest way that cosmetic dentistry can correct this is by teeth bleaching. But this alone may not entirely create a natural-looking appearance.

Size and Shape of Your Teeth

Size and shape also are major factors that define the appearance of teeth. The most common cause of changing tooth size and shape over time is tooth wear; and the most common cause of wear is tooth-to-tooth contact, or grinding. Wear on the edges of the teeth can give the appearance of aging because you do not show as much of your teeth when you smile. Another factor that affects how much of your teeth show when you smile is the loss of skin tone as you age.

This loss of tone causes your face to sag, thereby showing less of your upper teeth and more of your lower teeth. The aesthetic dentistry treatment to enable more teeth to show when you smile will depend on the cause. If the cause is due to wear of the teeth, dental veneers or dental crowns can be used to regain the lost length and fill out the smile. On the other hand, this may not have a significant effect if the cause is due to the loss of skin tone associated with age. If this is the case, plastic surgery may be indicated as part of the treatment.

Wear on teeth also will make the edges of the front teeth very flat. As this occurs, the edges of the front teeth will form a straight line rather than the more youthful appearance when the two front teeth are slightly longer than the teeth next to them. Also, as they wear, the proportion of length to width will be altered. Teeth will start to appear more square in their shape rather than rectangular.

Basically, any treatment that counteracts the above-mentioned appearance changes has the ability to enhance the appearance of your teeth and smile. The aesthetic dentistry treatment can vary from teeth bleaching to dental crowns or dental veneers. Depending on the severity, other forms of treatment such as braces and gum surgery also may be indicated to enhance the appearance and function of your teeth. It is important to remember that all areas need to be addressed. If treatment for teeth that are worn and dark only involves teeth bleaching, the final result will be whiter teeth that are still worn and short. The teeth will not appear natural, as there will be a conflict between white teeth (youthful) and worn teeth (aged) that do not work together. Instead, it is necessary to correct the color, size, and shape to create a more natural appearance.

By Greggory Kinzer, DDS, MSD

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.